28047 Radical resection of tumor (eg, sarcoma), soft tissue of foot or toe; 3 cm or greater

Name of the Procedure:

Radical Resection of Tumor (eg, Sarcoma), Soft Tissue of Foot or Toe; 3 cm or Greater

Summary

In this procedure, a surgeon removes a large tumor (3 cm or greater) from the soft tissue of the foot or toe. The goal is to excise the tumor completely to prevent its recurrence or spread. This procedure is often necessary for treating cancerous tumors like sarcomas.

Purpose

• Medical Condition: Primarily used to treat soft tissue tumors, such as sarcomas, which occur in the foot or toe.
• Goals: To remove the tumor entirely, reducing the likelihood of cancer spreading or returning, and to preserve as much normal tissue and function as possible.

Indications

• Presence of a soft tissue tumor measuring 3 cm or greater in the foot or toe, confirmed to be malignant (cancerous) or suspected to be so.
• Conditions like tenderness, swelling, or a palpable mass in the foot or toe.
• Diagnostic imaging (MRI, CT scan) suggests the presence of a sizable tumor.

Preparation

• Pre-Procedure Instructions: Patients may be required to fast (no food or drink) for at least 8 hours prior to surgery. Medication adjustments might be necessary, especially blood thinners.
• Diagnostic Tests: Pre-operative imaging studies and possibly a biopsy to confirm the nature of the tumor. Blood tests and a complete medical evaluation to ensure the patient is fit for surgery.

Procedure Description

• Steps:
  1. Administration of anesthesia, typically general anesthesia.
  2. Surgical site is sterilized and marked.
  3. An incision is made over the tumor site in the foot or toe.
  4. The surgeon excises the tumor along with a margin of healthy tissue to ensure complete removal.
  5. The surgical site is closed with sutures or staples.
  6. A dressing is applied to the wound.
• Tools and Equipment: Scalpel, surgical scissors, forceps, retractors, electrocautery device.
• Anesthesia: General anesthesia for complete sedation.

Duration

The procedure typically takes between 1 to 2 hours, depending on the size and location of the tumor.

Setting

The procedure is performed in a hospital or specialized surgical center.

Personnel

• Surgeon: A specialized orthopedic or oncologic surgeon.
• Nurses: Assist with the surgery and provide pre- and post-operative care.
• Anesthesiologist: Administers anesthesia and monitors the patient’s vital signs during the procedure.

Risks and Complications

• Common Risks: Bleeding, infection, reaction to anesthesia, swelling.
• Rare Risks: Nerve damage, recurrence of the tumor, incomplete removal of the tumor.
• Management: Follow-up care, antibiotics for infections, pain management, additional surgery if necessary.

Benefits

• Expected Benefits: Complete removal of the tumor, reduced likelihood of recurrence, preservation of foot or toe function.
• Realization: Some benefits can be seen immediately, while others, such as reduced risk of recurrence, may be long-term.

Recovery

• Post-Procedure Care: Wound care instructions, pain management, possibly antibiotics.
• Recovery Time: Generally, several weeks; patients may need crutches or a walker.
• Restrictions: Avoid weight-bearing activities on the affected foot/toe; limit movement as advised.
• Follow-Up: Regular appointments to monitor healing and ensure the tumor has not returned.

Alternatives

• Other Options:
  • Radiation Therapy: Non-surgical option that uses high-energy rays to shrink tumors.
  • Chemotherapy: Drug treatment that can shrink or kill cancer cells.
• Pros and Cons: Surgery is often definitive but involves more immediate risks and a longer recovery. Non-surgical treatments might be less invasive but can be less effective for large tumors.

Patient Experience

• During the Procedure: The patient will be under general anesthesia and will not feel anything.
• After the Procedure: Pain, swelling, and discomfort in the surgical area are common; pain management will be provided. Special care to avoid infection and ensure proper healing will be necessary. Lessons in wound care and possibly physical therapy to regain function and strength.